Nephrology Dialysis Transplantation, Vol 14, Issue 6 1418-1424, Copyright © 1999 by Oxford University Press
M Macanovic, M Hogarth and P Lachmann
Background: It has previously been reported that
patients with systemic lupus erythematosis (SLE) and glomerulonephritis do
not have anti-(deoxyribonucleic acid) DNA antibodies in their urine. This
finding was attributed to specific entrapment of anti-DNA antibodies by the
immune complexes in the glomerular capillary walls.
Methods: This phenomenon has been re-investigated as
part of a study of the use of desoxyribonuclease 1 (DNase 1) to treat lupus
nephritis (LN). For this purpose an ELISA was developed for the detection
of anti-DNA antibodies in urine. It was found that such an assay was very
susceptible to the presence of DNase in urine which destroys the antigen
coating the plates and gives rise to false negative results. For this
reason, it is essential that all tests for anti-DNA antibodies in the urine
are carried out in the presence of EDTA to inhibit the endogenous DNase 1
activity. Results: Using this assay to test the urine
from 24 patients with LN and non-selective proteinuria, it was found that
they all contained anti-DNA antibodies. The amount of anti-DNA antibodies
detected in the urine was compared with that expected by calculations from
the anti-DNA antibody titre in the serum and total immunoglobulin levels in
serum and in urine. It showed that in 20 patients there was neither
specific entrapment nor specific excretion of anti-DNA in urine, only the
expected among of leakage. In only three patients was any appreciable
entrapment demonstrated and in only one, any excess excretion.
Conclusions: It is suggested that the failure to
detect anti-DNA antibodies in the urine in the previous work was due to
failure to inhibit the endogenous urinary DNase. It remains to be determine
whether the retention of anti-DNA antibodies or excessive secretion is
correlated with clinical phases of LN. Key words:
anti-DNA antibodies; glomerulonephritis; NZB/NZW F1 hybrids; proteinuria;
systemic lupus erythrematosus; urine
ORIGINAL ARTICLES
Anti-DNA antibodies in the urine of lupus nephritis patients
Molecular Immunopathology Unit, MRC Centre, Cambridge, UK; Department of Rheumatology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK; Corresponding author at: West Dorset General Hospitals NHS Trust, West Dorset Hospital Renal Unit, Williams Avenue, Dorchester, Dorset DT1 2JY, UK
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